In October 2019, the Normandy Regional Health Agency asked Public Health France to investigate a suspected cluster of pediatric cancers in Eure, reported by parents of sick children. In order to evaluate the spatio-temporal grouping, the method used consisted in finding retrospectively whether an excess of pediatric cancers was observed in a defined geographical area, compared to the cancer frequencies observed in metropolitan France. Cancers identified between 2017 and 2019 were included. Two analyzes were conducted, on the one hand for all cancers and on the other hand for leukemia, the most frequent cancer in children. Two geographical areas were defined: one on a municipal scale, maximizing the risk of observing an over-incidence and the other on a cantonal scale, minimizing the risk of observing an over-incidence. The investigation identified 11 children who had been diagnosed with cancer over the period studied. No excess cases were found when taking into account all cancers. When the analysis was restricted to leukemia cases, an excess of cases was highlighted in the geographical area corresponding to a group of municipalities (SIR = 6.4 [2,3-14,0]). This excess was not found when the analysis focused on the cantonal grouping (SIR = 2.3 [0,8-5,0]). An epidemiological study was conducted using a questionnaire with parents and an environmental inventory was carried out on known environmental risk factors. This study did not aim to find individual causes of each cancer but rather to find a common factor between the children, specific to the geographical area, which could explain the grouping of cases and on which it would be possible to act. The investigations carried out did not identify any common factor in the sick children and the environmental inventory did not find any particularity. In the absence of an etiological hypothesis, carrying out a specific environmental measurement campaign was not justified. Consequently, in the absence of identified environmental and epidemiological causes, the hypothesis adopted in the current state of knowledge is a one-off grouping of pediatric cancer cases. Public Health France recommends continuing to monitor the occurrence of new cases of pediatric leukemia in the geographical area.
Author : Martel Melanie, Sirejacob Yoann, Erouart Stéphane
Year of publication: 2021
Collection : Studies and surveys